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AAPS: A crank medical “association” promotes COVID-19 disinformation

The AAPS is a far right-wing crank medical organization. Unsurprisingly, it’s all in with COVID-19 disinformation and pseudoscience.

I’ve been writing about the Association of American Physicians and Surgeons (AAPS) since I first discovered this far right wing/libertarian crank organization disguised as a legitimate medical society and its crank journal, the Journal of American Physicians and Surgeons (JPANDS) in 2006. At the time, I noted that the group was pretty much a fusion of a John Birch Society-like right wing group with a medical society and that it trafficked in the most vile antivaccine misinformation (e.g., that shaken baby syndrome is a “misdiagnosis” for vaccine injury and Andrew Wakefield’s recent claim that the measles vaccine will result in a mass extinction of humans), anti-immigrant fear-mongering, climate science denial, blaming breast cancer on abortion using execrable “science,” and more. The AAPS views doctors as some sort of mythical brave mavericks outside the herd whose godlike total autonomy must never be infringed by the government or anything else and rejects even the concept of a scientific consensus about anything. (Donald Trump’s first Secretary of Health and Human Services, Tom Price, is a member of AAPS.) Earlier this year, it’s even sued to protect its “right” to promote antivaccine misinformation. So naturally, six months plus into the COVID-19 pandemic, I wondered with AAPS was up to with respect to medical and political issues surrounding coronavirus. I was not surprised to learn that it’s as cranky and pseudoscientific as ever from their email newsletter. (Yes, I’m on a fair number of crank mailing lists. I do it for blog material.)

First up, from Monday, we have Dr. Jane Orient, the executive director of AAPS, whom we’ve met before, such as when during the 2016 election cycle she promoted the myth at the time that Hillary Clinton had Parkinson’s disease and peddled antivaccine conspiracy theories around Zika virus). She’s also on record as denying the very concept of a scientific consensus about anything. Unsurprisingly, her email claims that masks don’t work to slow the spread of COVID-19 (because, being a right wing organization, of course AAPS doesn’t accept that masks work):

We’re supposed to follow “evidence-based medicine” these days, but there is no firm evidence to support the masking and “social distancing” mandates being imposed throughout the land. CDC chief Robert Redfield asserts his opinion that the U.S. could get the coronavirus under control in 4 to 6 weeks if everyone wore a mask. He relies largely on a study of masking health care workers and patients in a Massachusetts health system.

Dr. Redfield is a political hack, which is a large part of the reason why the CDC has performed so poorly in response to the COVID-19 pandemic. He’s in over his head. I always thought his statement about masks from last week published in JAMA was irresponsible hyperbole. The editorial, actually, isn’t as overblown as it was portrayed in the news, as it actually makes no claim that universal masking would get the pandemic under control in 4-8 weeks. Apparently, he did say it in this discussion on YouTube, though, with Dr. Howard Bachner, the Editor-in-Chief of JAMA. As for the study, it was a nice observational study that showed that universal masking at Massachusetts General Hospital was associated with significantly lower rates of positivity for SARS-CoV-2 (the virus that causes COVID-19). The study has some weaknesses and potential confounders, but overall it’s pretty strong evidence for the efficacy of masking in healthcare settings. Yes, it might not apply outside of healthcare settings, but, as I said, Redfield is a hack. Even so, the MGH study was not the only study that his JAMA editorial relied on.

In actuality, the evidence that masks have a significant effect in preventing the spread of COVID-19 has been accumulating for quite some time, although that hasn’t stopped cranks from promoting disinformation about masks.

Cue Dr. Orient:

We have had some large experiments underway. In the U.S. we have recently had thousands of protesters crowded together, chanting and shouting. We also have large homeless camps. No masks, no distancing, no handwashing, and no constant sanitizing of anything a human might have touched. Are the surges of positive tests coming from there?

Yes, in the several weeks since the Black Lives Matter protests erupted, it’s become clear that, contrary to the fears expressed by some, the protests appear not to have led to a surge in COVID-19 cases. Paradoxically, they might actually have slowed the spread of COVID-19 in cities with large demonstrations. I’ll be honest, though. The “study” referenced to support this possibility was published as a white paper by the National Bureau of Economic Research by economists with no expertise in epidemiology or infectious disease. So I take it with a huge grain of salt. Basically the findings led the authors to speculate that the large protests increased stay-at-home behaviors among non-protesters, thus slowing the spread of coronavirus. Whatever one thinks of this particular study, though, it’s quite clear that, contrary to the fears hyped by those opposed to BLM and even some of us who support it, the mass protests appear not to have led to detectable increases in COVID-19 transmission attributable to the protests. Of course, the reason is probably that the vast majority of those protesters were also very good about wearing masks and, when possible, observing social distancing, and that these protests were outdoor protests.

None of that stops Dr. Orient from JAQing off:

Does the absence of reports mean that it’s safe to protest, at least for the correct cause, or to live on the streets? Maybe so, if you’re outdoors. (Then why should anyone wear a mask outdoors?) Maybe we just don’t know because contact tracers don’t ask.

Had persons who are testing positive been in Mexico, where cases are surging? (In Chula Vista, Calif., the majority of COVID-positive emergency-room patients had been in Mexico.) Were the “cases” confined to a nursing home, unable to go anywhere or even to have visitors? Were they alone except when breathing the air in a supermarket where an unmasked person might have been? We don’t know.

JAQing off, for those not familiar with skeptical lingo, refers to “just asking questions.” It’s a tried-and-untrue crank technique designed to make wild assertions and speculations seem palatable by making them in the form of questions rather than statements. The idea is to ask leading questions in order to influence the views of those listening to be receptive to the misinformation being implied.

In this case, Dr. Orient’s JAQing off plays on the racist anti-immigrant conspiracy theories beloved of AAPS that foreigners are bringing disease into this country, in this case COVID-19. Of course, one can’t help but add a sarcastic rejoinder: Given that the US only has 4% of the world’s population but has still managed to amass 25% of the world’s cases of COVID-19 and 25% of the world’s deaths from coronavirus, in reality shouldn’t it be other countries who fear Americans bringing disease and death to their countries? In fact, that’s already happened. The EU won’t let Americans in.Indeed, most of Europe and most of Asia are currently off-limits to American travelers, and the list of international destinations that still welcome Americans is now quite small.

The story referenced is also not exactly as presented. It’s a story from early June of how Americans living in Mexico were crossing back to the US to seek medical treatment. There is, of course, evidence that travelers from other countries did spark COVID-19 outbreaks in the US very early on in the pandemic, for instance from China in January and February before the travel ban. However, since at least February, it’s been community spread of the virus that’s fueled the rise in COVID-19 cases and deaths.

Next up, Dr. Orient pulls the Sweden gambit:

There is international experience, notably in Sweden. Children went to school, mask-free, behaving like normal children. There were no lockdowns, and the economy did not crash. There were fewer deaths on a per-capita basis than in locked-down, economically devastated New York (see figure below). As observed on Twitter, if New York had been a drug and Sweden a placebo, the trial would have been stopped in April for ethical reasons.

Included in the email was this chart:

AAPS Sweden

Comparing Sweden to New York State, for instance, rather than surrounding countries, is an intentionally deceptive way of framing the issue. Per million people, Sweden has suffered 12 times more deaths than Norway, seven times more than Finland and six times more than Denmark, for instance. It also turns out that Sweden has not been doing that well. and didn’t avoid economic pain after all:

Sweden’s central bank expects its economy to contract by 4.5 percent this year, a revision from a previously expected gain of 1.3 percent. The unemployment rate jumped to 9 percent in May from 7.1 percent in March. “The overall damage to the economy means the recovery will be protracted, with unemployment remaining elevated,” Oxford Economics concluded in a recent research note.

This is more or less how damage caused by the pandemic has played out in Denmark, where the central bank expects that the economy will shrink 4.1 percent this year, and where joblessness has edged up to 5.6 percent in May from 4.1 percent in March.

In short, Sweden suffered a vastly higher death rate while failing to collect on the expected economic gains.

In addition, the majority of cases and deaths in New York State were in New York City, which has as of today 227K confirmed cases and nearly 23,000 deaths, while New York State has 413K confirmed cases and 32,000 deaths. What’s different about NYC compared to Sweden? It’s a very densely packed metropolis. Finally, NYC and NYS are actually doing pretty well right now, with zero deaths from COVID-19 reported in NYC on Monday, only two in NYS.

Next up, Dr. Orient returns to masks:

You can spend $70 on a fashion mask. It is probably not FDA-certified, but an FDA certificate may be meaningless. After 4 hours of wear, you should wash a cloth mask and dry it in the sun.

For a summary of the evidence, see Mask Facts, the Doctors for Disaster Preparedness Newsletter, January 2020, and an extensive review by the Center for Infectious Disease Research and Policy (CIPRAP).

The first bit is obviously an appeal to ridicule, a logical fallacy. So what if you can buy a fashion face mask? One would think that, über-libertarian capitalist organization that AAPS is, rejecting, as it does, any hint of government regulation of physicians or government funding of health care, Dr. Orient would approve of entrepreneurs seeing a business opportunity and seizing on it to make a decent profit. As for the “extensive review,” I can’t help but note that it was published on April 1, nearly four months ago. Science changes, and evidence has been accumulating since then supporting the efficacy of face masks has been accumulating steadily.

One also notes that the Doctors for Disaster Preparedness is an AAPS-adjacent crank organization that shares its antiscience views, including anti-environmental forms of denialism (including DDT ban myths, ozone depletion denial, global warming denial, and crank theories about radiation hormesis) and medical denialism (vaccine denial and HIV denial). Unsurprisingly, its masking article includes some JAQing off parroting the anti-BLM and anti-immigrant sentiments that Dr. Orient did:

Contact tracers are to be deployed by hundreds of thousands to interview persons who test positive, to find and isolate persons who might have been near them. It would instead seem logical to ask sick people where they might have been exposed, as when investigating an outbreak of food poisoning. Asking about attending a Black Lives Matter protest is off-limits, at least in New York. And what about border crossing?

It just happens that surges in border states have occurred in border counties, coinciding with a COVID surge in Mexico. The three Rio Grande Valley counties—Starr, Hidalgo, and Cameron—had a 29% hospitalization-to-case ratio in early July, when the rate for the U.S. was 5.8%. This suggests that seriously sick patients may be crossing the border in search of treatment (tinyurl.com/y88cvxz3).The number of illegal immigrants crossing the southern border surged 40% in June (tinyurl.com/yaj6dt3x).

I refer to my previous rejoinder. The rest is a combination of cherry-picked studies, incidents, and disinformation, false comparisons, and even lies about how masks supposedly cause harm through being a “breeding ground for bacteria and fungi” and the accumulation of virus. (They don’t, and medical contraindications to wearing a mask are rare.) There’s also a bit of “whataboutism”:

While COVID-19 “case” counts dominate the news, where is the coverage on public and private debt, loss of tax revenue, rampant fraud in aid programs, corruption and malfeasance in the FBI and other government agencies, and other urgent issues?

Could it be because coronavirus pandemic remains the worst single health crisis in a century and there’s no sign of its ending any time soon? Just a thought.

As for “Mask Facts,” it’s a mixture of deceptively framed information, cherry picked science, and spin that might well be worth its own post, given how long this post has grown.

Yes, AAPS is doing what AAPS always does, promoting science denialist misinformation and disinformation. I’m only surprised it took me so long to get around to looking at the misinformation it’s promoting.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

84 replies on “AAPS: A crank medical “association” promotes COVID-19 disinformation”

I think there is plenty of blame to go around the room.
Hydroxychloroquine: Dr. Harvy Risch, epidemiologist at Yale, calculates that HCQ at the outpatient level would save 100,000 lies. His statement: The propaganda war against HCQ is not based on medical facts. (And by the way this is true: the proposed mechanism of action, well understood, is most effective at the outpatient level, as a prophylactic and interruptor of disease progression).
Coronavirus and bleach: I think we all remember the media uproar of Trump, bleach and the coronavirus. The EPA recommends chlorine dioxide to be used by both water treatment facilities and hikers to decontaminate water that contains bacteria, parasites and viruses, as the resulting water is very potable and better testing than the standard of using chlorine. To a lay person, without a strong science, background chlorine dioxide is a form of bleach (at the chemical level, not all that different from bleach).
The US is doing a bad job. We are actually doing a job on par with most of the European countries, when corrected for population size.
The corona virus will kill 2,000,000 Americans. The data is based on the now discredited (and by the, has been discredited for years) Imperial College model.
The incessant posting of positive cases and deaths without reference to context gives a misleading picture. The latest data suggest that the virus is on the as a moderately bad flu season.

Don’t treat the viral infections with steroids. Oh, the late stages of the virus, of which immune dysfunction is the hallmark, must be treated with steroids.
Masks don’t work. Oh wait, masks do work.

But perhaps the biggest deception of all: a highly contagious virus, that i s all ready endemic in the population, can be contained. By definition, a pandemic results when a pathogen enters the general, usually immunologically naive population. Once this occurs, containment is not possible. Trying to contain the virus at this point is about as effective as closing the barn doors after the horses have left.

I don’t think the level of lies about HCQ that need saving is quite at 10,000.

I suspect most of the claims that it works were more along the line of over-optimism and hype than lies.

Note that quite a few countries have contained the virus.

As a non-MD, it’s hard to get even a fuzzy idea of what value HCQ or HCQ+x has for treating this disease. The French study was merde, as is its author. Other practitioners seem to have had differing results.
The best I can do from both limited input and very limited resources to process it is that (it seems) HCQ is useful at some stages of the disease for some not all and perhaps not most patients, until better treatments are available, and (like most Rx) it can be deleterious at the wrong time/patient condition/etc.

Dr. Harvy Risch, epidemiologist at Yale, calculates that HCQ at the outpatient level would save 100,000 lies. [sic]

And where would that calculation* be? It’s not in his atrociously written AJE manuscript.

*Not to be confused with begging the question.

Trust a true zealot to bring back HCQ where no-one was talking about it. You forget zinc and a few antibiotics, so I only give you a D+.

Also, re: Coronavirus and bleach
Trump was not talking about topical use/disinfection of water/whatever normal people use bleach for.
He was talking about injecting it into Covid19-infected patients. Along or in addition with some sunshine. Or maybe vaporizing it into the lungs. That last one may be actually working, except it requires surfactants, i.e. something closer to soap than to bleach, so, no, still a bad idea.
I have the script from his ramblings somewhere, if you want to.
Stop insulting our intelligence by pretending to reveal to us how to disinfect something.

Seriously, go drink HCQ or inhale bleach, while looking at the sun, and stop pestering us.
Twit.

Here is the mechanism as to why HCQ may work:
The virus enters the cell by binding the AEC2 receptor and the glycan coat. it requires the TMPRSS2 fusion protein for activation of the virus and entry into the cells. HCQ impairs viral entry into the celll. It does this as it alters the glycation of AEC2 receptor that binds the virus and it blocks the sialic acid receptor so that the virus cannot bind to the cell. It also alters TMPRSS2 fusion protein, so that the virus is not activated and cannot enter the cell. It may interfere with viral replication as it raises the pH of the endoplasmic reticulum. The virus requires a low pH. It is not clear if this latter action can be achieved at pharmacological doses. For these effects to be meaningful the medication must be given early and also suggests it will act as a prophylactic.

Antibiotics are necessary after day 3. The reason is that the virus is now in the cell and replicating. The patient is at risk for alteration of the immune system, which presents on day 7 to day 9 as hyper-coagulation and shortness of breath. To transition from a viral infection to this stage endotoxemia is required. Antibiotics blocks endotoxemia formation.

Empirically zinc seems to be a useful adjunct based on anecdotal reports. The mechanism to explain this is not clear. Zinc has potent anti-viral properties when applied to mucosal surfaces but whether or how zinc supplementation is effectiv is not clear.

Not everyone exposed to the virus develops the disease. Most do not. One major finding is that hyperglycemia identifies a patient a high risk. The mechanism is known. Hyperglycemia inactivates IRF5. Lack of IRF5 allows autoimmunity to develop. The cytokine storm that kills is an overwhelming autoimmune respons.

Diabetes type 2 is a high risk factor. The mechanism is known. DMT2 have an altered inflammatory response (with predisposition to autoimmune disease) with an increase in TH17/TH1 phenotype. TH17/TH1 is the hallmark of an autoimmune reaction.. They are usually hyperglycemic. They are usually obese. Obesity also alters the immune response and sets up an autoimmune reaction.

Low vitamin D. Vitamin D is a hormone made on exposure to sunlight. Vitamin D is necessary for optimal response of the immune system. The major effect is to suppress autoimmunity and induce a state of tolerance. At the same time it changes the M1 pro-inflammatory macrophage to the M2 anti-inflammatory macrophage. It changes the immune reaction from an elevation of TH17/TH1 to a TH2 reaction. Those with low vitamin D are at risk. This usually correlates with low sunshine exposure. Sunshine is also necessary for optimal response of the immune system and settng of the circaian rhythm (also necessary for optimal repsonse of th immune system).

Estrogen and progesterone are protective and found in high levels in wome less than 65. As we age, the levels drop and the protection drops. Testosterone is detrimental as it increaes the activity of TMPRSS2. TMPRSS2 is the fusion protein required for entry of the virus into the cell. Males are at slightly increased risk because of this.

Those who die loss develop lymhopenia with an alteration of the T helper/T suppressor cell ratio due to loss of THelper, not dissimilar to t same reaction in HIV. Why this is the case is not clear but may represent a combination of poor T cell function that occurs as age, exacerbated by diabetes type 2, especially if on oral hypoglycemic agents such as metformin that impair the ETC (electron transport system) energy production.

The disease is really two diseases. A viral like syndrome and an overwhelming immune reaction called a cytokine storm, most likely the culmination of all of the above.

As to bleach: Trump is neither a scientist nor a physician. He asked a reasonable question.

@Pathcoin

“and it blocks the sialic acid receptor so that the virus cannot bind to the cell.”

I would be super interested in hearing more about this. Is this why it is not dangerous to bats? {sorry about comparing you to Chrome}

The virus enters the cell by binding the AEC2 receptor

It’s almost as though I’ve read this comment before, typos and all. Oh, wait.

@ Pathcoin

“As to bleach: Trump is neither a scientist nor a physician.”

Yeah. Right. Merely the President of the United States of America.

@Pathcoin:
There you go again with the Vitamin D and sunshine.

Again, the highest rates of infection and death in the US are currently in the Sun Belt. Do you know what there is a lot of in the Sun Belt? Sunshine!
Which pretty much completely refutes that point.

Also, do people who die of COVID-19 have more or fewer TH1/TH17 cells? You say it both ways. I’m surprised your own TH1 cells haven’t slapped you for the mindbogglingly stupid things you say.

There you go again with the Vitamin D and sunshine.

Perhaps the solution to the “AEC2 receptor” issue is that turns everything into Garamond.

^ BTW, has its timing changed since this?

The disease progresses from a viral like syndrome (prior to day 7) to a transition phase (between day 7 and 9) which is characterized by onset of shortness of breath and tightness in the lungs, with or without evidence of coagulopathy to requiring oxygen supplementation to ventilation support.

^^ OK, this is getting boring, but it does seem to be slowly adjusting the narrative, to wit:

It’s not clear if the alteration of cellular pH can be achieved at pharmacological doses.

Oho! After a month and a half, things have been nailed right the fuck down:

It may interfere with viral replication as it raises the pH of the endoplasmic reticulum.

The Golgi apparatus, of course, has an alibi, but I’m interested in the ins and outs of the casus omenti.

@JustaTech

“It changes the immune reaction from an elevation of TH17/TH1 to a TH2 reaction.”

“Those who die loss develop lymhopenia with an alteration of the T helper/T suppressor cell ratio

I think he may be saying both. That is, those bits not being converted can contribute to a cytokine storm and that those bits early in the disease are depleted in the elderly to fight the virus in the first place.

Also, I’m starting to think that the top post dumping of some trumpLard’s email is not the real Pathcoin. The paragraph blocking is all wrong. People can be mean and confusing.

Some projects may have funding issues so that no public-facing new ‘training’ is occuring, many petaflops a day of compute can get pricey:

https://talktotransformer.com/

You clearly don’t understand how science works if you’re upset that recommendations have changed as new information emerges.

How about this for an analogy: you must wear only and all of the clothing that you wore at midnight on New Year’s Eve, 2019. You may not take any new information into account with your clothing choices such as changes in weather or whatever activities you are doing. Wouldn’t that be silly?

Just as you change your clothing depending on new information about the weather, doctors and scientists change their recommendations (refine might be a better word) based on new information.

Now go drink your gin and tonic and read a book.

Summertime Clothes in the age of Sars-CoV-2:

https://youtu.be/GxhaRgJUMl8?t=3

A few years ago, there was this lot (vacation bible school, I think) across from the gas station that actually had some kind of contact sport with people running around and bouncing off each other in these big bubbles with legs. If football came back doing that, I might actually watch it.

@Pathcoin

Stop it, Pathcoin. You are about two iterations away from pulling a full-on Tay.

Could you please let Pathcoin1 out? Get him elaborating on:: IL-6 supression and covid-19/treatment, please.

But, what is Pathcoin. I mean, I kinda think I know what a Bitcoin is — Bitcoin is like you let your car idle all night and it spits out solved sudoko puzzles that I may trade for heroin.

But Pathcoin has devoled into — I left Chrome open all night and my battery ran down. And I’ve got…Nothing??? (sorry, the simile eludes me.)

Like 1984, Too Much and Never Enough was not meant to be an instruction manual, Pathcoin.

Bad parenting, I guess.

@ Tim

“Bad parenting, I guess.”

If that’s one insult I heavily dislike seeing used on people, it’s this one. In italian, though, I do confess, it can sound really nice and snappy: “Maleducati”.

But, honestly, being badly raised up should be enshrined as being a human right. One more that won’t get China’s approval… Sigh…

@F68.10

I$Wish$we$had$a$secret%$laungauge$between$&us.I$$think$$is#an^^[email protected]@prototype%%AI)model. And he’s being a very very naughty boy! the consequences of ‘bad parenting’ may be about to be taken to a whole new r/nextfuckinglevel

The fact that organizations that usually argue against science-based intervention like vaccines because “big Pharma bad” are now fighting a non-pharmaceutical, low cost intervention like masks really makes it hard not to see them as simply anti-public-health or pro-disease rather than against any type of corruption for really concerned about pharmaceutical companies.

Have the effects of masks as used by the general US public ever been studied in relation to transmission of this virus? At first, it would seem they work – they slow the ejection of particles, so said particle don’t travel as far. One would hope that by the time the particles drift over to others they’ve degraded by, oh, the assumption that they degrade fast enough to become less infections.

But hope is a garbage plan. What happens to exhalations in practice? What else happens? Those particles don’t disappear, and on masks average people actually use they aren’t held on the inside forever. Look outside a technical setting and you’ll see not only the chin-mask but the under-nose mask, the outside mask which is removed indoors, over-a-thick-beard mask, the amazing moveable mask, juggling between neck, chin and face, and the Congressional under-nose mask, the last being a favorite of those who consider themselves special.
Yeah, the greenest lab tech or nurse’s assistant knows better, but the public out in averageville doesn’t operate like that. The population of Averagevill knows what it wants, which is to do what they feel like, when they feel like it.

Such speculation provides no quantified information. One would have to set up a test with average people, not eager to participate college students or hospital workers, and then measure effectiveness in some approximation of the chaos of real life. Good luck getting anyone with enough talent and discipline to run such a study.

Good afternoon, David. There was another missive in my mailbox this am:

How Many COVID Deaths Are Needless?

Dear Liz​:

I hope you stay well, but if COVID-19 strikes you or a loved one, I hope you can find a doctor willing and able to help you.

Yale epidemiologist Harvey Frisch
told Laura Ingraham that the anti-malaria drug hydroxychloroquine (HCQ) could save up to 100,000 lives. But you probably won’t be able to get it. If you have symptoms of COVID-19, with or without a positive test, your doctor may tell you to stay home, isolate yourself, take Tylenol for symptoms, and go to the ER if you can’t breathe.

Once in the hospital, you might—or might not—get the $3,000 new drug remdesivir or qualify for a clinical trial. If you get HCQ it will likely be too late to help. Antiviral drugs need to be given early.

HCQ was FDA approved in 1955 and has been taken safely by hundreds of millions of people. High government officials who are determining federal policy insist in private that doctors have the legal authority to prescribe HCQ or other FDA-approved drugs for “off-label” uses. However, the FDA has refused to reverse statements that state and local authorities cite to threaten doctors or pharmacists who provide you with this cheap remedy.

AAPS has filed for an injunction
to force the FDA to stop obstructing use of this drug, while it hoards and wastes the millions of doses that manufacturers donated to the Strategic National Stockpile.

If a drug could save 100,000 lives, then government agencies that block its use are responsible for 100,000 needless deaths.

In some countries in Central America, officials are going door to door to distribute HCQ. Poor countries that allow free use of HCQ
have far lower death rates than rich countries that hinder it.

For a summary of the evidence on HCQ, see c19study.com

Jane M. Orient, M.D., Tucson, AZ

Executive Director, Association of American Physicians and Surgeons (AAP
.

@ lizditz

Could you drop it with HCQ, please? It’s old news.
Nothing the guy says here is news. All of these arguments have been debated and counter-argumented to death in the past four months.

Athaic, Liz is just providing a background for the 100000 people meme. Pretty sure she’s on the side of logic and science. Although my memory these days…..

Pretty sure she’s on the side of logic and science.

Irrespective of your memory, she is.

Yes, Liz was providing the source for the 100,000 lives saved, parroted by Pathcoin. It originates from Fox News, unsurprisingly. Anything said on Fox News becomes the Gospel for some people.

FOR PEOPLE WITH READING COMPREHENSION ISSUES, THESE ARE NOT MY VIEWS. I AM QUOTING AN EMAIL FROM JANE ORIENT, AAPS

Today’s missive:

Will a COVID-19 Vaccine Save the Day?

DearLiz​:

I hope that you and yours are weathering the storm in a crashing economy, but recovery depends on ending the pandemic.

Hopes are riding on a “warp-speed” vaccine. During this week’s coronavirus briefing, President Trump said his administration had reached an “historic agreement” with Pfizer
to manufacture and deliver 100 million doses of its vaccine after it is approved for use, and eventually 500 million doses. The deal is worth $1.95 billion. This suggests that approval is assured.

Safety testing for the Pfizer vaccine
was completed in 45 subjects. The highest of three vaccine doses was associated with fatigue, headache, or chills in more than 70% of recipients. Only the lower doses were used for the second injection, which caused more reactions than the first. More than half of those who received the intermediate dose (30 mcg) reported fever, fatigue, headache, chills, or muscle pain, and 100 percent reported headache after the second dose. But only a few were judged to be severe, so further testing could proceed.

A rival vaccine is being developed by Moderna, which is recruiting 30,000 volunteers for Phase 3 efficacy studies at 89 sites in the U.S. A preliminary report
on 45 subjects showed that all recipients of the intermediate or largest dose had some type of systemic reaction after the second injection (muscle or joint pain, fever, headache, chills, or fatigue), most judged to be mild or moderate.

It is too soon to rule out long-term complications such as autoimmune disease.

Despite his support for a vaccine, Trump also said, “You tell me, but I almost would prefer the therapeutics even first. You go into the hospital and you make people better. But we’re doing very well with remdesivir and other things. Steroids are turning out to be great, plasma is turning out to be good.”

He did not mention hydroxychloroquine (HCQ), which can also be used as a prophylactic at a dose as low as 200 mg/month. Prophylaxis is the approach used for malaria or HIV, for which there is no vaccine despite decades of effort. Patients are also given prophylactic antibiotics if exposed to tuberculosis, meningitis, anthrax, or other diseases.

Jane M. Orient, M.D., Tucson, AZ

Executive Director, Association of American Physicians and Surgeons (AAPS)

I have reading comprehension issues and I’m unsure if “warp-speed” is really a literal thing.

However, the FDA has refused to reverse statements that state and local authorities cite to threaten doctors or pharmacists who provide you with this cheap remedy.
.
.
If a drug could save 100,000 lives, then government agencies that block its use are responsible for 100,000 needless deaths.

People should just grow their own HCQ plants. It’s the real thing, not synthetic; it is also more holistic/synergistic thay way.

https://www.indiatoday.in/fact-check/story/fact-check-can-kalonji-seeds-cure-covid-19-truth-behind-viral-myth-busted-1665269-2020-04-10

https://theprepared.com/blog/mysterious-seeds-in-the-mail/

But, of course, if Biden gets elected he will task his stormtrooper goons to run around looking for clandestine HCQ grow operations, stopping and searching everybody in case they have some, busting in people’s houses and shooting their dogs,…, coming into the schools and doing presentations warning of the addictiveness of of HCQ and showing beautiful before/horrific after photos and testimonials about how HCQ destroys lives.

We the American people cannot risk having to endure the living hell that is Joe Biden’s America! Now get out there this November 3’rd and beat(up) those socialists at the poles!

Orient is a loon–yet another one that medical boards won’t sanction even though it’s clearly allowed in a pandemic/national emergency setting (and this is my state, Arizona…also too cowardly to go after antivax quack Jack Wolfson)

On the bright side, Facebook restrictions on antivaxxer Jennifer Margulis’s for-profit pages have hit her hard enough that she’s put out a “help I’m being censored” post. I hope Facebook’s lockdown saves parents from Margulis’s lies and pseudoscience.
https://jennifermargulis.net/censorship-in-america-is-getting-out-of-hand/

re Margulies:
Heh heh.
There are a lot of pleas like that going around the net because there has been some pushback against misinformation by Facebook, YouTube, Wikipedia, Twitter leading to complaints and alternate bios by the usual suspects.
I wish that there was more.
I noticed that a few sites ( Stop Mandatory Vaccination Facebook do NOT come with a warning)
and that anti-vaxxers ( AoA, TMR, Del, Null, Adams etc) continue to solicit funds for their “charities” which specialise in promoting misinformation.

Is it possible that social media action has led to a cut in revenue?

So what is it about right wing crank organisations and hydroxychloroquine?

This is starting to have all the shades of alternative medicine arguments. First it was just hydroxychloroquine plus azithromycin. When evidence started to arise that outcomes were not significantly better, it became it only works if you give it early. As data evolved that early use did not prevent disease or hospitalisation (This for example), it became it has to be used with zinc.

There was only a modicum of a priori evidence that hydroxychloroquine would work. It had effects in lab bench studies. However, it has done this for many viruses, but that has yet to translate into an effective treatment for any of these viruses. In the early days of the pandemic it may have been worth a try, but why would there be an expectation for efficacy with COVID-19 when it has not worked for any other virus? It is best put in the basket of treatments shown not to be effective and left alone. The idea that it is saving 100,000 lives is arrant nonsense.

It is a viscious and surreal feedback loop between right wing media (Murdock et al.) And Trump. They spout crap and show things in a light that they know will appeal to his ego, world view, or spoken blather of the moment. It is a little more than just ‘carrying his water’; It is some Cult of Personality or something. Trump says something stupid and because he said it that is the way it is. He doubles down and keeps doing that (see: Sharpiegate). Trump sees something stupid on Faux so that must become policy or ammunition to defend his original stupid. All this sometimes at the expense of his advisers and the rest of the administration.*

Trump can’t seem to process information correctly and he (a recent reality tv host) sees everything in terms of ratings of him (Why should we have our numbers double because of one ship?). And his people seem to be reluctant to show him information that would displease him in the first place as evidenced below in a striking sit down interview with Fox’s Chris Wallace (I was shocked they let that air, frankly) where he proudly presented a flakey chart). Where he claimed we have the lowest CFR (“mortality”) in the world — We were #7 lowest at the time.

Trump has spent the last couple days bragging about passing a dementia test — He is quite proud of himself — where one of the questions was to go back and remember the answer to a previous task (remember a string of words).

…Can you do that again? And you go person.. woman man… camera.. tv. .. If you get it in order, you get extra points… And you go person..woman…man. camera tv. They say, “That’s amazing. How do you do that?” I do because I have like.. a good memory? Because I’m cog ni tively there..

There is a meme going around that Trump has spent more time bragging about passing a dementia test than Obama did after winning a Nobel Prize.

https://youtu.be/W6XdpDOH1JA?t=2

*–And as I stood there in the beautiful Rose Garden contemplating my awesome power and gravity of what a historic thing I just did I crapped myself in my pants. The wettest of craps from the standpoint of water.

–No, No! He didn’t crap himself; What meant was…..

–Yes I did to crap myself and I’ll do it again.

Trumps cognitive test has according to Trump really hard questions for the last five. These include:

What is today’s date?
What day of the week is it?
Where are you?
What city are you in?

To be fair, those questions would be kinda hard to answer for a time traveler that didn’t bother to buff up on the preamble for his journey and jusk kind of hopped on the ride before being examined and meeting the criteria of ‘my hands must be relatively this big before riding’.

@Chris, I might have to stop and think about the day/date ones, but that’s because quarantine life has made it very clear that dates and days of the week are a social construct. Every day is Monday, is also Friday, is also September.

@ Terrie,
There is defenitly a difference between the current weather and that near the end of september. Besides the sun gets up later.

Trump’s cognitive test…

Lines that cement presidents in history.

“Four score and seven years ago”

“The only thing we have to fear is, fear itself”

“Ask not what your country can do for you, ask what you can do for your country.”

“Mr. Gorbachav, tear down this wall.”

Today, our fellow citizens, our way of life, our very freedom came under attack in a series of deliberate and deadly terrorist acts.

If there is anyone out there who still doubts that America is a place where all things are possible; who still wonders if the dream of our founders is alive in our time; who still questions the power of our democracy, tonight is your answer.

Person, woman, man, camera, tv.

The REAL cognitive test is that if you ever required one because professionals were suspicious of your level of functioning , you would AT LEAST know enough to not broadcast it
He doesn’t know why being tested in itself is significant. He thinks that his “success” is actually an accomplishment! Even if a person didn’t study this, they might wonder why they are being asked questions of this nature..

@ Tim

“There is a meme going around that Trump has spent more time bragging about passing a dementia test than Obama did after winning a Nobel Prize.”

I’ve seen people undergo dementia tests. And seen their rights to autonomy significantly curtailed. I vehemently oppose restricting a person’s autonomy based merely on such tests. While Alzheimer patients indeed need at some point to have their autonomy curtailed, it shouldn’t be done just anyhow, with moral standards that I do consider low, and very obviously not in a “prophylactic” perspective.

“I’ve seen people undergo dementia tests. And seen their rights to autonomy significantly curtailed.”

Well thank goodness he passed it then. It would be terrible for him to be restricted from twitter — people might forget that he is just not right with just days left before the election.

https://youtu.be/GDgVLpehajs?t=1

As for the rest, I agree. But I also feel Dumbp is a real danger to everything. FauxSpews has goaded him into sending in the federal brown shirt goons which I fully envision will be at many select polling places come whenever that day may be.

I’m starting to think it was a bad idea to hang up my long-held obsession over John of Patmos’ perceived prescient novella and feeling I saw aspects of it at every level.

At the very least, the way I see it going down is ‘Merica is about to have its “I won by 99%, would have been 100% without all the rampant voter fraud” moment. After that, we fall into a DJTjr/Eric oscillatory well for quite some time — And half the nation seems to want this. Salivate for this.

It is like some hidden and twisted neuro-linguistic signal is blasting out somehow and it has infested every institution and individual. To wit, my little Pc buddy up above who seems to have a latched up FPGA somewhere* that has rendered the First Law (of robotics) into (1) It is forbidden to contradict Trump— Do the very best you can, give us the best science and wording you can without violating this prime directive. (2) It is required to be supportive of Trump — So long as it does not contradict with the first law, and so on.

The latest example in ‘meat space’ would be today’s release of the bowdlerized CDC school opening guidelines. — Trump first said No. Too hard. To expensive. Do it again and do it right this time.

*alas, it seems not to be that he’s just patriotic but misguided, afterall

@ Tim

“But I also feel Dumbp is a real danger to everything.”

Well, personally, there are issues I find more serious than coronavirus. Kurdistan, for instance. And, yep, he screwed up big time, and proved he was more than a danger.

A danger indeed is something that has not yet gone over the tipping point into outright damage. Trump has gone over that tipping point and is now in the “outright damage” zone.

So do not count on me to defend Trump. Though I must admit that my anti-humanist corrupt and twisted mind does massively enjoy the freak show. Quite curious to know whether or not he’ll be reelected.

In other news… non-news?

I watched 22 minutes of the Kennedy-Dershowitz “debate” ( link is at Age of Autism- You Tube 1:18 total)
and while Dershowitz illustrated how the Court ruled on Jacobson, he appears to be giving Kennedy space to argue about “safety of vaccines” and exemptions based on medical or religious issues. He mentioned: the armed forces can compel a person to go to war where they might be injured or killed. Vaccines don’t only protect others but the vaccinated person as well He notes how he and Kennedy had previously discussed vaccine safety.
Kennedy, early on, admits a rate of 2 or 3% “serious” AEs not “one per million”
I couldn’t stand any more of them..

Someone who may be more tolerant might view the whole video.

@ Deni¢e writes, “Someone who may be more tolerant might view the whole video.” Hey. Thanks for the reminders! I was only able to catch the last 30 min live. If I have time, need to view from the beginning if it doesn’t disappear from the interwebs. From what I could gather, looks like RFK, Jr. enlightened the Dershowitz on a few key points.

Even more interesting is why the Dershowitz agreed to debate in the first place. The dude has represented the scourge and scum of society. Definitely not the best pick for the “provax”, pHARMa, and public healthscare officials or maybe he is? LOL!

https://en.wikipedia.org/wiki/Alan_Dershowitz

He probably agreed to debate because he’s not sufficiently versed in anti-vaccine tactics to know he’d be facing a dishonest Gish Gallop, and that although his agreed to participate on an understanding that “we are not going to discuss the science, just the law,” the anti-vaccine activist would not respect that.

That’s why most people who understand how anti-vaccine activists act don’t fall into such traps.

It’s a little sad that you need to imagine that he represents anyone but himself.

Note, by the way, that although the anti-vaccine sites have implied this is a live debate, it was actually pre-recorded before any announcement was put up – likely exactly to avoid anyone warning Dershowitz of where the traps will be.

NW: “Even more interesting is why the Dershowitz agreed to debate in the first place. The dude has represented the scourge and scum of society…”

….and thus inoculated himself against the revulsion he must have felt for a sleaze like RFK Jr., who grossly insulted victims of the Nazis by likening vaccination to the Holocaust.

I expect Dershowitz sincerely believes everyone deserves representation. I agree with that, though I don’t know that I would be willing – or suitable – to a career representing people accused of – or guilty of – serious crimes.

I expect many lawyers believe they can handle any discussion, and do not account for the extensive work science deniers put into constructing false realities.

I agree with that, though I don’t know that I would be willing – or suitable – to a career representing people accused of – or guilty of – serious crimes.

I’m still bummed out that Ken White seems to have abandoned his blog, Popehat and gone for Twattering. To the best of my recollection, he started out as a federal prosecutor (AUSA?) and then switched to defense. It was freewheeling, whimsical, and rigorous.

I’m better for having found it, but I think I’d say the same thing about the late, lamented Big Dead Place.*

*I once actually was about to put in for an overwinter gig as IceCube support at Amundsen–Scott, and then, one day, I thought, “well, I suppose this Raynaud’s might be an issue” and so forth.

@ Dorit Rei$$ writes, “Note, by the way, that although the anti-vaccine sites have implied this is a live debate, it was actually pre-recorded before any announcement was put up – likely exactly to avoid anyone warning Dershowitz of where the traps will be.”

Pre-recorded? Really? And you know this because…

Likely exactly? Traps? Seriously? You are cracking me up! And I’m accused of being a conspiracy crank? LOL!

I know it because when the first announcement went up, I emailed Alan Dershowitz. I said that I hope he’d reconsider, but if not, here are common points of misinformation that Kennedy likes to use, and how they’re misleading (points that were repeated in this debate – for example, the misleading claim that vaccines are not placebo tested, which is untrue). Dershowitz responded immediately saying: “The discussion was taped last week. I didn’t debate the science; I debated only the law and morality.”

That was right after the anti-vaccine sites started publicizing. So at that point, the debate was already recorded.

And yes, traps. Your leaders mislead using a number of tactics. I understand why they would rather not have Dershowitz warned (and I do realize that they were also worried that someone would convince him to withdraw. I would have loved to convince him not to play into Kennedy’s hand, but I judged the likelihood low, so also gave him the information).

@ Prof Dorit:

At the start, we are informed that Drs Hotez and Offit declined ( probably because they knew what kind of nonsense RFK jr would issue forth).

Also, Nathalie is rather naive in assuming that I am paid for my writing ( note her use of a cent icon in my name- my machine doesn’t even have one!) which is quite juvenile and misleading because I have NEVER received anything for expressing my beliefs- beliefs grounded in facts. Actually, I have little need of compensation because I have never really needed to work: I own properties, investments and rents due that cover my needs,( I’ve also worked as a counsellor, educator, advertising artist- writer and tax advisor to small business people). I’ve been fortunate enough to have acquired a first rate education from elitist universities ( heh) in diverse subjects which I SHARE with whomsoever appreciates it as well as having had a family who taught me how to invest wisely, to be self sufficient. and to consider others’ lacks.
Because of my good fortune, I have time to follow charlatans and cranks like RFK jr and MANY others who hoodwink unsuspecting souls like the scoffers we have at RI
.
Believing that everything is done for money perhaps reveals the core beliefs of the accuser.

They have to believe it’s a conspiracy, and that people speaking up are doing it for monetary motives. Otherwise they would have to face the simple reality that extensive data shows their beliefs wrong, and most scientists and experts disagree with them.

I’m not surprised they didn’t find someone who knows the topic willing to meet RFK jr. on apparently equal terms. He’s not equal to an actual expert.

@ Dorit Rei$$ – You emailed the Dershowitz? Colleague of yours? You discouraged him from doing the debate? This is your “proof”? ‘Cuz you said so? Okay Dorit. Gotta’ go. I can only take so much hilarity these days.

I don’t know Prof. Dershowitz. I have read a book by him about twenty years ago. But I looked him up online, and sent an email.

My proof is what he said. Which was that at that point, the discussion was already recorded.

I would assume he would know, wouldn’t you?

@ Dorit Rei$$ (Love these dollar signs… they always denote an absolute lack of bias…)

“I would assume he would know, wouldn’t you?”

You seem to have reading comprehension issues.

She was calling you a liar. Technically.

I hate breaking it to you.

Ah, I was running around all day, but I’m pleasantly surprised to have lately learned that Dr. Fauci threw out the first pitch of that which is going to be a Real $eason, dammit.

Cardboard cutouts in the seats. Laugh tracks..ehemm.. crowd noises. Could this not be better served with actual live-time post production of NPC crowds? And proceedurally generated noises? He asks himself through clenched teeth. Ohh. The Players wouldn’t see it, I guess. Never mind.

I’m disappointed in Fauci.

He strides to the mound looking determined and confident, then uncorks a wild toss that doesn’t get within a country mile of the plate.

Dude’s got to up his game.

Quoting someone else on the internet “Dr Fauci pitched so badly because he didn’t want anyone to catch anything.”

As someone who’s never really gotten baseball (and only played softball under threat of lacrosse), why is the season so long?

Both: why is the season spring through fall, and, why are there so many games? I can’t think of any other sports where professional teams play two games in a day (or do they not do double-headers anymore?)

When I lived in Boston in high school I remember there were already “big games” during finals, which was an issue when everyone else in the class was a rabid Sox fan and the game went to 3am the night before the physics final.

Isn’t 60 games plenty to figure out who goes to the post-season?

@Natalie White Kennedy is a liar, so he forget to mention to Dershowitz that a clinical has a control group. So question is, how many side effects placebo “causes” (number of background problems) FDA analysis of Gardasil is here:
https://wayback.archive-it.org/7993/20170722072816/https://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM111274.pdf
Go to table 44. Gardasil group 0.9 % and control group 1.1 %.
Why would somebody whose children are suffering serious side effects would not go to Vaccine Court ? It is absolute free, after all, and you need only show probable cause. This is way one per million is an overestimate.

@ Arno:

I watched the rest of the video and RFK jr proceeds exactly as I expected.

Rather than wade through his murky swamp of mis-informtaion, I suggest looking at Orac’s post of
March 5, 2020:
Children’s Health Defense: Ten Lies about Vaccines **
which details his usual explanations and why they fail to pass the smell test.

He misleads Dershowitz into thinking that the “debate” was to be about law when it was about vaccines and research ( from his jaundiced eye)

One note: he purports that since 1900 or so, sanitary conditions improved and that the number of deaths was already going down which doesn’t address the facts that the rate of infection didn’t decline until the vaccine became available AND airborne diseases like measles. Many woo-meisters use these

** if you Search his name, you will get many hits about how he dis-informs Orac’s been after him for many years.

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